Wednesday, March 24, 2010

The head CT was read as normal yesterday afternoon, but when I looked at it I thought there was a stroke on the left side. And I didn't trust the person who'd read it, so I called the night radiologist (who I do trust).

Dr. Radar: "Night desk."

Dr. Grumpy: "Hey, it's Grumpy. I'm looking at the head CT on Mrs. Stroke. It was read yesterday as normal, but I think there's a stroke on the left."

Dr. Radar: "Hang on... No, that's not a stroke. If you look at the other images, it's just artifact."

Dr. Grumpy: "Are you sure? It really looks like a stroke to me."

Dr. Radar: "Positive. Definitely artifact."

I disagreed, but it's his specialty, and I respect him. I got off the phone and began writing my note. About a minute later a nurse came over to say Dr. Radar had called back looking for me.

Dr. Grumpy: "Grumpy."

Dr. Radar: "Yeah, it's Radar again. Did you say the thing on the right or the left?"

Dr. Grumpy: "Left".

Dr. Radar: "Sorry, I thought you said right. Oh yeah, that's definitely a stroke on the left."

You aren't helping my confidence in radiologists what so ever! A surgeon quoted to me recently that in his experience, radiology is wrong 1 out of 3 times. Hence he requires the patient to bring the films to him. Is that statistic accurate? Personally, the radiologists missed a fractured vertebra on two different occasions, caught only by the surgeon. I'm starting to wonder...

Yeah, hearing that he called you back does make me think he'd be a good doctor to have.

I've had a few really bad experiences with doctors who couldn't read the results of all kinds of tests, or forms with lists of meds the patients are allergic to, or whatever else. One guy instructed that a group home should give a woman ibuprofen on the same form as (and on the line directly under) a note that said she was allergic to Motrin. (I wouldn't have used a brand name, but I wasn't trusted to write the form out.) One resident claimed an elderly woman was drug-seeking and discharged her over my objections (and then objected to her using a wheelchair to get to the cab), only to have whoever reviewed his work call on Monday morning to insist that she come in right away for surgery on her broken hip. And so on. (And that's just doctors!)

Everybody makes mistakes. People who are aware that they sometimes make mistakes and do their best not only to not make them in the first place but to catch and fix them once they have made them are the ones you want handling important things. If I ever have a stroke, I hope it's one that many people can't see on the head CT. And I hope I have someone like Dr. Radar who double checks so that anything that needs to be found is actually found.

My clients will confuse their horse's left vs. right legs. "Well, Doc, it's the leg on the left if you're standing in front of him, but it's the one on the right when you're sitting on him looking down..."

Kinda like "skier's right or left" - ie the right as you are skiing down the hill, NOT as you look up at it. Still, the main question I have is, did the patient obviously have a stroke clinically? If so, who cares about the CT if there is no blood on it? The MRI would confirm of refute the clinical findings.

And he did catch his mistake, and pretty quickly. Given this was night shift, I'd right this off to lack of sleep/caffeine. After all, I don't know how many early mornings in college I got up and poured myself a glass of milk and put orange juice on my cereal....

Welcome to my whining!

This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.

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